Surgery centers saved the Medicare program $7.5 billion between 2008 and 2011, and could contribute to more than $57 billion in additional savings over the next decade, according to a University of California-Berkeley study.
Researchers at the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare set out to determine how much the Medicare program and its beneficiaries save when procedures are performed at ASCs instead of HOPDs, and how much those savings would grow if more procedures migrated to ASCs in the future.
Their analysis of procedures performed in both settings, corresponding reimbursement rates and the predicted number of Medicare beneficiaries from 2013 to 2022 revealed that:
- During the 4-year period from 2008 to 2011, because ASCs are paid an average of 58% of the HOPD reimbursement rate, surgery centers generated a total of $7.5 billion in savings for the Medicare program and its beneficiaries.
- The savings increased each year, rising from $1.5 billion in 2008 to $2.3 billion in 2011. This increase resulted from the total number of overall surgical procedures growing from 20.4 million to 24.7 million between 2008 and 2011, as well as from the widening reimbursement rate gap between HOPDs and ASCs. Additionally, the savings were realized despite the share of total Medicare procedures performed in ASCs decreasing from 22.9% in 2008 to 21.7% in 2011.
- If ASCs' share of procedures or Medicare procedure volume remain constant over the next decade, surgery centers will save the Medicare program an additional $32.5 billion. However, if ASCs' share of procedures increases even slightly, the savings could exceed $57.6 billion over 10 years.
ASC Association CEO William Prentice says surgery center growth has stalled, and some centers are being purchased by hospitals and turned into HOPDs. Those factors are limiting the cost-saving potential of ASCs, he says, adding, "Congress and the Obama administration must ensure that Medicare payments for ASC services are sufficient so that ASCs can continue to be the lower-cost alternative for outpatient surgical care for America's seniors."
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